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Mental & Psychological health
of Women
What is mental &
Psychological health
Mental health & Women
“Women all over the world are the
biggest consumers of health care. They
live longer than men and have more
illness and disability than men. They
receive doctor’s surgeries more than men,
fill more prescriptions, have more
surgical procedures and occupy about 6070% of hospital beds”
(Ann Tinker world Bank)
•Women are most likely than men to suffer from Major
depression
• Lifetime risk of depression for women is 10% to
25% versus 5% to 20% for men
•Between 10%-15% of women who give birth will
develop post-partum depression
•Women develop many anxiety disorders more than men.
•Women are 2-3 times more likely to have panic disorders.
•Slightly more women than men develop Alzheimer disorders.
•More than 75% of Migraine sufferers are women
Depression in Women
Today depression is a major public health problem.
It will be the second greatest cause of death and
disability world wide by the year 2020 (WHO 1998)
Epidemiological data worldwide clearly demonstrates
that major depression is approximately twice as
common in women as in men.
Its onset peaks during the child bearing years of life
Depression in treated sample also shows an
approximately 2:1 female male ratio. (this not due to
help seeking behavior of women, same ratio exist in
community prevalence)
Causes
According to different researches purposed possible
reasons of why depression is more in women than
men is
•Genetic factors
•Fluctuations in hormones levels from adolescence
through menopause and during menstrual cycle
•Social, economic, life stresses, vulnerable situation of
young mothers
(Dr.Shifa Naeem –Pakistan ,FCPS thesis)
Anxiety disorders in Women
•Anxiety disorders are most common psychiatric disorders.
•In general population their prevalence is one in ten
individuals (Robbins & Bland et al 1988)
Lifetime rates of anxiety disorders in male & female from
community surveys
Men %
Women %
Panic with Agoraphobia
2.9%
7.7%
Simple Phobia
7.2%
13.9%
Social Phobia
2.3%
3.2%
PTSD
6.0%
1.3%
Obsessive Compulsive disorder
2.0%
3.3%
Unaiza Niaz (2000)
Panic Disorder
•Panic disorder can occur on its own or with Agoraphobia.
•Agoraphobia is the fear and avoidance of place from which
escape might be difficult and it may develop as a consequence
of panic attack.
The hallmark of panic disorder is panic attack ,which is an
acute discrete episode of somatic symptoms such as
•Shortness of breath
•Hyperventilation
•Chest discomfort
•Palpitations
•Trembling
•Shaking & cold palms
•Feeling of dizziness
•Getting out of control
•Fear of death
Premenstrual Dysphoric Disorder
Women have known for centuries that there are both
physical and emotional symptoms before and during
menstruation. In ancient cultures women were
isolated and restrained from doing housework or
participating in social activities.
Criteria
•Depressed mood and feeling of hopelessness
•Anxiety/Tension
•Mood swings (low mood, tension, mood swings,
anger/irritability)
•Anger/irritability
•Feeling of being out of control
•Decreases interest (work, school, social activities)
•Difficulty in concentration
•Low energy
•Food craving
•Sleep disturbance (hypersomnia or insomnia)
•Physical symptoms
•Backaches
•Headaches
•Increase in weight
Diagnostic criteria
•Minimum 5 signs and symptoms
•2 consecutive cycles
•Functional impairment
•At least one mood sign or symptom (low mood, tension,
mood swings, anger/irritability)
Causes
Abnormal level of oestrogens, progesterone, follicle
stimulating hormone (FSH), Luteininzing Hormone
(LH),cortizone.
Risk factors
•Women with postpartum depression
• Mood changes induced by contraceptives
•Family history of depression
Perimenopause & Menopause
Menopause is the point at which a woman has
permanently ceased menstruation.
Perimenopause typically occurs 5-7 years before
menopause. It is interval between regular ovulatory
menstrual cycles and complete cessation of ovarian
function
Climacteric is a generalized term used to describe
the declining ovarian function.
Effect of Hormonal changes on women
mental health
•Depression
•Mood swings
•Anxiety
•Brain & Behavior
Estrogenic effects on specific cognitive functions like
short term verbal memory…………………..
Visuospacial memory …………………………Estrogen
Replacement therapy
Stress
•Physical changes
•Adjustment issues
•Self image
Strategies
•Awareness regarding mental health issues
•Quality of mental health services
•Improve state gender policies
•Work on primary prevention mental disorder
•Research / surveys are needed in this area